Job Summary We are seeking a NetworX Configuration Analyst to support provider contract pricing, reimbursement configuration, and claims adjudication within the NetworX Pricing platform. The ideal candidate will have strong healthcare payer experience, expertise in NetworX and FACETS, and the ability to translate provider contract requirements into accurate system configurations.
Key Responsibilities
Configure and maintain provider contracts, fee schedules, qualifier groups, and reimbursement methodologies in NetworX.
Analyze business and contractual requirements and translate them into system configurations.
Perform pricing validation, claims analysis, testing, and production support.
Investigate and resolve pricing, reimbursement, and claims adjudication issues.
Collaborate with Provider Contracting, Claims, Business, and IT teams to implement configuration changes.
Support User Acceptance Testing (UAT), production releases, and post-implementation validation activities.
Create and maintain configuration documentation and testing evidence.
Must-Have Skills
Hands-on experience with NetworX Pricer and NetworX Modeler.
Experience in provider contract and reimbursement configuration, including fee schedules, pricing methodologies, and network reimbursement.
Knowledge of FACETS configuration and claims adjudication.
Experience Required: 7+ Years
Applicant Notices & Disclaimers
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At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws.This position's pay range is $60.00/hr - $60.70/hr.
